Vasoactive exposures during pregnancy and risk of microtia.
Vasoactive exposures during pregnancy and risk of microtia.
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怀孕期间的血管活性暴露和小耳症的风险。
DOI：
10.1002/bdra.23101
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
NationalBirthDefectsPreventionStudy
中科院分区：
文献类型：
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作者：
VanBennekom,CarlaM;Mitchell,AllenA;Moore,CynthiaA;Werler,MarthaM;NationalBirthDefectsPreventionStudy
非综合征性小耳畸形的病因学知之甚少。本研究调查的假设，小耳畸形是由血管disruption.METHODSThe研究分析数据，从人口为基础的国家出生缺陷预防研究（NBDPS）之间的交付1997年和2005年。将411例非综合征性小耳畸形病例（有或无其他缺陷）与6560例非畸形婴儿在围受孕期母亲暴露于血管活性药物和吸烟以及先前与血管事件相关的条件（多胎妊娠、母亲1型、2型或妊娠期糖尿病史和高血压）方面进行比较。采用多变量模型估计比值比（OR），控制种族/民族、教育、围受孕期叶酸使用和研究中心的影响。血管活性药物和吸烟的风险估计值没有显著增加。母亲1/2型糖尿病是在怀孕前或怀孕期间诊断的，分别为4%和1%，对照组为1%和0.05%;这两组合并的校正OR为7.2（95%置信区间[CI]，3.9 - 13.1）。在9%的病例和6%的对照中观察到糖尿病; OR中度升高（OR，1.4; 95% CI，0.9 - 2.0）。多胎妊娠的OR也增加（OR，2.5; 95% CI，1.5 - 4.2）和既存高血压（OR，1.6; 95%CI，1.0 - 2.5）。结论：由于OR仅在糖尿病中升高，而在血管活性暴露或其他潜在血管事件中不升高，研究结果表明，一些小耳畸形的发生可能是糖尿病胚胎病的一部分，而不是血管破裂的表现。出生缺陷研究（A部分），2013年。© 2012 Wiley Periodicals，Inc.
BACKGROUNDLittle is known about the etiology of nonsyndromic microtia. This study investigated the hypothesis that microtia is caused by vascular disruption.METHODSThe study analyzed data from the population‐based National Birth Defects Prevention Study (NBDPS) for deliveries between 1997 and 2005. Four hundred eleven nonsyndromic cases of microtia, with or without additional defects, were compared to 6560 nonmalformed infants with respect to maternal exposures to vasoactive medications and smoking during the periconceptional period and conditions that have previously been associated with vascular events (multiple gestation, maternal history of type 1, type 2, or gestational diabetes, and hypertension). Odds ratios (ORs) were estimated with multivariable models, controlling for the effects of race/ethnicity, education, periconceptional folic acid use, and study center.RESULTSRisk estimates for vasoactive medications and smoking were not meaningfully increased. Maternal type 1/2 diabetes was diagnosed before or during the index pregnancy in 4% and 1% of cases, respectively, compared to 1% and 0.05% of controls; the adjusted OR for these two groups combined was 7.2 (95% confidence interval [CI], 3.9–13.1). Gestational diabetes was observed for 9% of cases and 6% of controls; the OR was moderately elevated (OR, 1.4; 95% CI, 0.9–2.0). ORs were also increased for multiple gestations (OR, 2.5; 95% CI, 1.5–4.2) and pre‐existing hypertension (OR, 1.6; 95% CI, 1.0–2.5).CONCLUSIONSBecause ORs were only elevated for diabetes and not for vasoactive exposures or other potential vascular events, findings suggest that some microtia occurrences may be part of the diabetic embryopathy rather than manifestations of vascular disruption. Birth Defects Research (Part A), 2013. © 2012 Wiley Periodicals, Inc.